Shown verbatim: the complete text as captured from the official PDF posted by the Arkansas General Assembly, fetched 2026-07-23. Page and line markers are part of the official record; nothing is edited or removed. The official bill page.
Stricken language would be deleted from and underlined language would be added to present law.
1 State of Arkansas A Bill
2 95th General Assembly
3 Regular Session, 2025 SENATE BILL 544
4
5 By: Senators M. Johnson, K. Hammer
6 By: Representatives Gazaway, Lundstrum
7
8 For An Act To Be Entitled
9 AN ACT TO AMEND THE ARKANSAS PHARMACY BENEFITS
10 MANAGER LICENSURE ACT; AND FOR OTHER PURPOSES.
11
12
13 Subtitle
14 TO AMEND THE ARKANSAS PHARMACY BENEFITS
15 MANAGER LICENSURE ACT.
16
17 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:
18
19 SECTION 1. Arkansas Code � 23-92-503, concerning definitions used
20 under the Arkansas Pharmacy Benefits Manager Licensure Act, is amended to add
21 additional subdivisions to read as follows:
22 (16)(A) "Opt-out contract" means an agreement or a contract in
23 which a pharmacy must proactively notify the pharmacy benefits manager if the
24 pharmacy wishes to opt-out of certain terms potentially leading to lower
25 reimbursement rates or network exclusions if the pharmacy does not opt-out of
26 the contract.
27 (B) "Opt-out contract" includes a term that requires a
28 pharmacy to take affirmative action to opt-out of certain terms or conditions
29 of the contract;
30 (17)(A) "Pharmacy benefits manager national contract to
31 pharmacies" means a standardized agreement entered into by a pharmacy
32 benefits manager and a network of pharmacies across the United States in
33 which a pharmacy is, either directly or indirectly, passed through a pharmacy
34 services administrative organization messenger model to agree to certain
35 pricing terms and conditions for a patient if that pharmacy is managed or
36 represented by a pharmacy benefits manager network.
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1 (B) "Pharmacy benefits manager national contract to
2 pharmacies" includes a nationwide network of pharmacies that have entered
3 into a contract for national reimbursement rates, terms, and conditions that
4 are not Arkansas-specific with a pharmacy benefits manager to provide
5 pharmacist services, including without limitation dispensing medications to a
6 patient within the pharmacy benefits manager network;
7 (18)(A) "Place on probation" means an enforcement action against
8 a pharmacy benefits manager for lack of compliance with the requirements of
9 the Arkansas Pharmacy Benefits Manager Licensure Act, � 23-92-501 et seq.
10 (B) "Place on probation" includes penalties of probation
11 and may include:
12 (i) Prohibiting on advertising or bidding on new
13 business or requests for proposals;
14 (ii) Requiring notification of probation to a
15 current contracted plan or program that is directly or indirectly funded by a
16 state appropriation to furnish, cover the cost of, or otherwise provide for
17 pharmacist services to an individual who resides in or is employed in this
18 state; or
19 (iii) Other penalties established by rule of the
20 Insurance Commissioner;
21 (19) "Underpayment violation" means:
22 (A) A violation of � 23-92-506(b);
23 (B) A violation of � 17-92-507; or
24 (C) A fair and reasonable compensation payment violation
25 as defined under � 23-92-506(a) and by rule of the commissioner; and
26 (20) "Unique combination for pharmacy claims" means a pharmacy
27 claims bank identification number, pharmacy claims group number, pharmacy
28 claims processor control number, or any combination of a pharmacy claims bank
29 identification number, pharmacy claims group number, and pharmacy claims
30 processor control number that is used by a pharmacy benefits manager to
31 process a pharmacy claim.
32
33 SECTION 2. Arkansas Code � 23-92-506, concerning prohibited practices
34 of a pharmacy benefits manager, is amended to add additional subsections to
35 read as follows:
36 (f) Upon request, a pharmacy benefits manager, including pharmacy
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1 benefits managers contracting for Medicare pharmacy and pharmacist benefits,
2 shall provide a pharmacy services administrative organization, pharmacy, or
3 pharmacist with each pharmacy claims bank identification number, pharmacy
4 claims group number, pharmacy claims processor control number, and each
5 unique combination for pharmacy claims for each pharmacy network established
6 or administered by a pharmacy benefits manager to enable the pharmacy
7 services administrative organization, pharmacy, or pharmacist to make an
8 informed healthcare contracting decision to support negotiating a new
9 contract or to exit or renew an existing contract.
10 (g) For a new contract, an opt-out contract, a contract amendment, or
11 a renewal of an existing network, a pharmacy benefits manager, including
12 pharmacy benefits managers contracting for Medicare pharmacy and pharmacist
13 benefits, shall clearly list for the pharmacy services administrative
14 organization, a pharmacy, or pharmacist each pharmacy claims bank
15 identification number, pharmacy claims group number, pharmacy claims
16 processor control number, and each unique combination for pharmacy claims for
17 each pharmacy network established or administered by a pharmacy benefits
18 manager to enable the pharmacy services administrative organization,
19 pharmacy, or pharmacist to make an informed healthcare contracting decision.
20 (h)(1) An opt-out contract shall include at least sixty-days notice to
21 the pharmacy services administrative organization, pharmacy, or pharmacist.
22 (2) The notice required under subdivision (h)(1) of this section
23 shall be sent by both email and fax.
24 (3) The opt-out option in an opt-out contract shall offer the
25 pharmacy services administrative organization, pharmacy, or pharmacist the
26 ability to notify the pharmacy benefits manager of the decision to opt-out or
27 remain in the network.
28 (4) If a pharmacy benefits manager has not received a reply from
29 the pharmacy services administrative organization, pharmacy, or pharmacist
30 within thirty (30) days of the first notice that the opt-out notice was
31 received, the pharmacy benefits manager shall send a notice to the pharmacy
32 services administrative organization, pharmacy, or pharmacist a notification
33 by certified mail of the opt-out contract.
34 (i)(1) A pharmacy benefits manager shall not offer "take it or leave
35 it" terms and conditions in a contract that would violate requirements of
36 state law.
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1 (2) A pharmacy benefits manager shall actively respond,
2 communicate, and adjust to the concerns of a pharmacy services administrative
3 organization, pharmacy, or pharmacist that proposed or existing contract and
4 provider manual terms do not follow state law.
5 (j) A pharmacy benefits manager shall not utilize a pharmacy benefits
6 manager national contract to pharmacies that does not include a separate
7 Arkansas-based amendment or Arkansas-specific contract that clearly complies
8 with this subchapter and other state laws.
9
10 SECTION 3. Arkansas Code � 23-92-508(c), concerning the penalties
11 under the Arkansas Pharmacy Benefits Manager Licensure Act, is amended to
12 read as follows:
13 (c) After notice and opportunity for hearing, the commissioner may:
14 (1) Impose a penalty of up to five thousand dollars ($5,000) per
15 violation against a pharmacy benefits manager if the commissioner finds that
16 the pharmacy benefits manager has not:
17 (A) Followed the process established for determining
18 pricing or costs under the Maximum Allowable Cost List under � 17-92-507; or
19 (B) Used the national average drug acquisition cost under
20 � 23-92-506(b); or
21 (C) Complied with the requirements of this subchapter;
22 (2) Revoke, place on probation, or suspend the license of a
23 pharmacy benefits manager or revoke, place on probation, or suspend the use
24 of a specific network used by a pharmacy benefits manager and identified by a
25 registered unique combination for pharmacy claims if the commissioner finds
26 that the pharmacy benefits manager:
27 (A) Has committed a pattern of violations of this
28 subchapter;
29 (B) Has not followed the process established for
30 determining pricing and costs under the Maximum Allowable Cost List under �
31 17-92-507; or
32 (C) Has not used the national average drug acquisition
33 cost under � 23-92-506(b); or
34 (D) Has violated this subchapter; and
35 (3) For a pattern of more than two (2) violations of this
36 subchapter, revoke, or prohibit a pharmacy benefits manager for up to three
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1 (3) years from bidding on new business opportunities with a plan or program
2 that is directly or indirectly funded by a state appropriation to furnish,
3 cover the cost of, or otherwise provide for pharmacist services to an
4 individual who resides in or is employed in this state.
5
6 SECTION 4. Arkansas Code � 23-92-508, concerning enforcement of the
7 Arkansas Pharmacy Benefits Manager Licensure Act, is amended to add an
8 additional subsection to read as follows:
9 (d)(1) The commissioner shall require a pharmacy benefits manager that
10 has an underpayment violation to:
11 (A) Pay twelve percent (12%) interest per month as a
12 penalty to the impacted pharmacy or pharmacist for pharmacist services on an
13 underpayment violation that is calculated on the number of days after the
14 claim was adjudicated until resolution of the underpayment violation; and
15 (B) Pay the entire amount of the amount of the
16 underpayment violation plus the required interest under subdivision (d)(1) of
17 this section to the impacted pharmacy or pharmacist for pharmacist services
18 on an underpayment violation.
19 (2) A pharmacy or pharmacist shall not be required to collect an
20 amount of an underpayment violation or interest from a patient in the form of
21 copay or out-of-pocket expense to the patient.
22
23 SECTION 5. Arkansas Code � 23-92-509(b)(1), concerning the rules for
24 the Arkansas Pharmacy Benefits Manager Licensure Act, is amended to read as
25 follows:
26 (b)(1) Rules adopted under this subchapter shall set penalties or
27 fines, including without limitation monetary fines, probation, suspension of
28 licensure or unique combination for pharmacy claims, and revocation of
29 licensure or unique combination for pharmacy claims for violations of this
30 subchapter and rules adopted under this subchapter.
31
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5 03/20/2025 3:05:26 PM ANS419Every fact on this page links to its source, starting with the official bill record.